PMID- 38457567
OWN - NLM
STAT- MEDLINE
DCOM- 20240311
LR  - 20240311
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 103
IP  - 10
DP  - 2024 Mar 8
TI  - Comparison of vonoprazan-based dual therapy with vonoprazan-based bismuth 
      quadruple therapy for treatment-naive patients with Helicobacter pylori 
      infection: A propensity score matching analysis.
PG  - e37476
LID - 10.1097/MD.0000000000037476 [doi]
LID - e37476
AB  - Vonoprazan, a novel acid suppressant and the first potassium-competitive acid 
      blocker, has the potential to enhance the eradication rate of Helicobacter pylori 
      due to its robust acid-suppressing capacity. This study aimed to compare the 
      efficacy of vonoprazan-based dual therapy (vonoprazan-amoxicillin, VA) with 
      vonoprazan-based bismuth quadruple therapy (VBQT) as a first-line treatment for H 
      pylori infection. This retrospective single-center non-inferiority study was 
      conducted in China. Treatment-naive H pylori-positive patients aged 18 to 80 
      received one of the 2 treatment regimens at our center. The VA group received 
      vonoprazan 20 mg twice daily and amoxicillin 1000 mg 3 times daily for 14 days, 
      whereas the VBQT group received vonoprazan 20 mg, amoxicillin 1000 mg, 
      clarithromycin 500 mg, and bismuth potassium citrate 220 mg twice daily for 14 
      days. The eradication rate was evaluated 4 to 6 weeks after treatment using the 
      carbon-13/14 urea breath test. Propensity score matching was used to analyze 
      eradication rates, adverse events (AEs), and patient compliance between the 2 
      groups. Initially, 501 patients were included, and after propensity score 
      analysis, 156 patients were selected for the study. Intention-to-treat analysis 
      showed eradication rates of 87.2% (95% CI, 79.8-94.6%) for the VA group and 79.5% 
      (95% CI, 70.5-88.4%) for the VBQT group (P = .195). Per-protocol analysis 
      demonstrated rates of 94.4% (95% CI, 89.2-99.7%) for the VA group and 96.8% (95% 
      CI, 92.4-100%) for the VBQT group (P = .507). Non-inferiority was confirmed 
      between the 2 groups, with P values < .025. The VA group showed a lower rate of 
      AEs (10.3% vs 17.9%, P = .250) compared to the VBQT group. There were no 
      significant differences in patient compliance between the 2 groups. In 
      treatment-naive patients with H pylori infection, both the 14-day VA and VBQT 
      regimens demonstrated comparable efficacy, with excellent eradication rates. 
      Moreover, due to reduced antibiotic usage, lower rate of AEs, and lower costs, VA 
      dual therapy should be prioritized.
CI  - Copyright (c) 2024 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Liu, Zhu
AU  - Liu Z
AD  - Department of Gastroenterology, Shandong Provincial Maternal and Child Health 
      Care Hospital Affiliated to Qingdao University, Jinan, China.
FAU - Chen, Xin
AU  - Chen X
AD  - Department of Gastroenterology and Hepatology, Tianjin Medical University General 
      Hospital, Tianjin Institute of Digestive Disease, Tianjin Key Laboratory of 
      Digestive Diseases, Tianjin, China.
FAU - Sun, Dong-Jie
AU  - Sun DJ
AD  - Department of Digestive Diseases, The Fuzong Clinical Medical College, Fujian 
      Medical University, Fuzhou, China.
FAU - Zhao, Wen-Wen
AU  - Zhao WW
AD  - Department of Gastroenterology, Shandong Provincial Maternal and Child Health 
      Care Hospital Affiliated to Qingdao University, Jinan, China.
FAU - Kou, Luan
AU  - Kou L
AD  - Department of Gastroenterology, Shandong Provincial Maternal and Child Health 
      Care Hospital Affiliated to Qingdao University, Jinan, China.
FAU - Zheng, Wen-Wen
AU  - Zheng WW
AD  - Department of Gastroenterology, Shandong Provincial Maternal and Child Health 
      Care Hospital Affiliated to Qingdao University, Jinan, China.
FAU - Hao, Jiao-Rong
AU  - Hao JR
AD  - Department of Gastroenterology, Shandong Provincial Maternal and Child Health 
      Care Hospital Affiliated to Qingdao University, Jinan, China.
FAU - Gao, Feng-Yu
AU  - Gao FY
AUID- ORCID: 0000-0002-7226-7842
AD  - Department of Gastroenterology, Shandong Provincial Maternal and Child Health 
      Care Hospital Affiliated to Qingdao University, Jinan, China.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - U015TT5I8H (Bismuth)
RN  - 0 
      (1-(5-(2-fluorophenyl)-1-(pyridin-3-ylsulfonyl)-1H-pyrrol-3-yl)-N-methylmethanamine)
RN  - 0 (Proton Pump Inhibitors)
RN  - 0 (Anti-Bacterial Agents)
RN  - 804826J2HU (Amoxicillin)
RN  - H1250JIK0A (Clarithromycin)
RN  - 0 (Pyrroles)
RN  - 0 (Sulfonamides)
SB  - IM
MH  - Humans
MH  - *Helicobacter Infections/drug therapy/etiology
MH  - Bismuth/therapeutic use
MH  - *Helicobacter pylori
MH  - Retrospective Studies
MH  - Propensity Score
MH  - Proton Pump Inhibitors/adverse effects
MH  - Drug Therapy, Combination
MH  - Anti-Bacterial Agents
MH  - Amoxicillin/therapeutic use
MH  - Clarithromycin/therapeutic use
MH  - Treatment Outcome
MH  - *Pyrroles
MH  - *Sulfonamides
PMC - PMC10919513
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2024/03/08 18:42
MHDA- 2024/03/11 06:42
PMCR- 2024/03/08
CRDT- 2024/03/08 14:23
PHST- 2024/03/11 06:42 [medline]
PHST- 2024/03/08 18:42 [pubmed]
PHST- 2024/03/08 14:23 [entrez]
PHST- 2024/03/08 00:00 [pmc-release]
AID - 00005792-202403080-00035 [pii]
AID - 10.1097/MD.0000000000037476 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2024 Mar 8;103(10):e37476. doi: 
      10.1097/MD.0000000000037476.